Some factors relating to intelligence in treated children with spina bifida cystica.

The 83 survivors of a consecutive series of children with spina bifida cystica, born between 1963 and 1971 and treated non-selectively since birth, were assessed by intelligence and developmental testing. In nine of the children who had not required shunts the distribution of intelligence was within the normal range. The need for a shunt was significantly related to the presence of craniolacunae and to the sensory level of the lesion recorded at birth. Seven of the 74 shunt-treated children had suffered ventriculitis, meningitis or septicaemia, and their intelligence was significantly worse than the others. In the 67 shunt-treated children who had not suffered infection, intelligence was significantly related to the thickness of the pallium when the shunt was inserted during the first four weeks of life, and to the sensory level of the lesion recorded at birth. Intelligence was not related to the function of the shunt at time of assessment, to the number of revisions of the shunt, or to the rate of increase in head size during the first four weeks of life. It is concluded that the best indication of later intelligence can be gained at birth from the thickness of the pallium and the sensory level of the lesion.